# PUYALLUP ENDOCRINE & NUCLEAR MEDICINE CLINICS

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1962525527
- **Authorized official:** DR. DONALD F DEVRIES M.D. (PRESIDENT)
- **Authorized official phone:** (253) 841-2471

## Contact information

- **Practice address:** 1011 E MAIN AVE, SUITE 302, PUYALLUP, WA 98372-6775
- **Practice address phone:** (253) 841-2471
- **Practice address fax:** (253) 841-2472
- **Mailing address:** 1011 MAIN AVE E, STE 302, PUYALLUP, WA 98372-6775
- **Mailing address phone:** (253) 841-2471
- **Mailing address fax:** (253) 841-2472

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207RE0101X | Endocrinology, Diabetes & Metabolism Physician | 601891662 | WA | Yes |
| 207UN0902X | Nuclear Imaging & Therapy Physician | 601891662 | WA | — |

## Other

- **Enumeration date:** 04/09/2007
- **Last updated:** 07/22/2014

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 113381 | LABOR & INDUSTRIES GROUP\# | WA |
| 05 | — | 7093685 | — | WA |
| 01 | — | CI9058 | RAILROAD MEDICARE | — |